Individual provider Active NPI

Cyrus Shawn Vepa, MD

  • Emergency Medicine Physician
  • Gadsden, AL
National Provider Identifier
1083660922
Registry record updated Aug 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
C0174 Issued in KY
Practice address
600 S 3Rd St
Gadsden, AL 35901-5304
Phone
(904) 805-1300
Fax
(904) 805-1302
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X C0174 KY Primary
Emergency Medicine Physician 207P00000X 14398 AL

Addresses

Primary practice location

600 S 3Rd St
Gadsden, AL 35901-5304

Mailing address

PO Box 863535
Orlando, FL 32886-3535
Phone (904) 805-1300

Other identifiers 2

IdentifierTypeStateIssuer
51519432OtherALBLUE CROSS
051519432MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
14398ALMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pickens County Health Care Authority Current Accepting new patients
Community Hospital Inc Current Accepting new patients
Shawmut Emergency Physicians Emergency Medicine Past Accepting new patients
Emcare Physician Providers, Inc. Emergency Medicine Past Accepting new patients
Clanton Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
Demopolis Emergency Physicians, LLC Emergency Medicine Past Accepting new patients
City of Jackson Healthcare Authority Past Accepting new patients

Locations

241 Robert K Wilson Dr
Carrollton, AL 35447
Phone (205) 367-2408

220 Hospital Dr
Jackson, AL 36545
Phone (251) 246-1159

805 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-6541

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629158400000",
    "number": "1083660922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 863535",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328863535",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S 3RD ST",
            "city": "GADSDEN",
            "state": "AL",
            "postal_code": "359015304",
            "telephone_number": "904-805-1300",
            "fax_number": "904-805-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEPA",
        "first_name": "CYRUS",
        "middle_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2021-08-17",
        "certification_date": "2021-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "C0174",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "14398",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51519432",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051519432",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gadsden, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.